Aj. Trevett et al., ANALYSIS OF REFERRAL LETTERS TO ASSESS THE MANAGEMENT OF POISONOUS SNAKE BITE IN RURAL PAPUA-NEW-GUINEA, Transactions of the Royal Society of Tropical Medicine and Hygiene, 88(5), 1994, pp. 572-574
Citations number
7
Categorie Soggetti
Public, Environmental & Occupation Heath","Tropical Medicine
A prospective series of patients envenomed after snake bite was seen a
t Port Moresby General Hospital (PMGH) Papua New Guinea, between Janua
ry 1991 and December 1992. Referral letters were received with 60 of t
he patients who had been initially seen at a health centre. These lett
ers were analysed in conjunction with our own clinical observations. T
he importance of non-clotting blood and local lymphadenopathy as early
signs of systemic poisoning did not appear to be universally recogniz
ed by staff in health centres. In some cases, no attempt was made to t
ransfer the patient to hospital until signs of neurotoxicity were esta
blished with potentially dangerous delay. Analysis of both hospital an
d health centre records suggests that the majority of deaths which occ
urred in Central Province, Papua New Guinea, during the period of the
study were due to delay in transfer to hospital. We suggest that all p
atients with unequivocal signs of envenoming in Central Province, Papu
a New Guinea, should be transfered to PMGH as soon as possible. Antive
nom should also be given as soon as possible, but this does not remove
the need for immediate transfer.